Pityriasis is an eruption of small furfuraceous substances on the skin of
the head, or the rest of the body, without ulceration. It is occasioned,
either by depraved humours which have been determined to the head, or by
a saltish phlegm, or by bilious or melancholic blood. After the general
system has been evacuated, as formerly described, we must use some of the
under-mentioned remedies. Having first macerated Cimolian earth in water,
mix with the juice of beet, and anoint it, allowing it to remain until
dry, then wash it away, and, having pounded frankincense with wine and
oil, anoint with them. Next day, rub in stavesacre with oil.—_Another_:
Of nitre, of the burnt lees of wine, of ben-nut, of each, lb. j; of
stavesacre, lb. iss. Dissolve in wine, and rub the head; or, if the rest
of the body be affected with tingling, it may be used dry. When the
pityriasis is more humid, wash with brine or the decoction of lupines. Of
this remedy I have had ample experience.
_On psydracia and exanthemata of the head._ The psydracia are small
protuberances, like blisters, elevated above the skin. The exanthemata
are superficial ulcerations, somewhat red and rough. Both are to be cured
by the under-mentioned remedies: Of litharge, dr. ij; of ceruse, dr. iv;
of alum dr. ij: of the green leaves of rue, dr. ij; pound with vinegar
and myrtle-oil, and anoint.—_Another_: Pounding rue and alum with honey,
anoint with this the head, after having first shaved it. If the head is
excoriated, apply olive leaves boiled with honey.—_Another_: Of litharge
and ceruse, of each, dr. xij; of native sulphur, dr. viij; mix with
myrtle cerate.
_For the thick and red ulcers of the head, resembling papulæ, or small
nipples, from which ichor is discharged._ Having first shaved the head
and scrubbed it with water and nitre, use native sulphur livigated with
human urine; or anoint with melanteria and vinegar.
_For achores and favi._ The complaint called achor is one of those
which affect the skin of the head, corroding the skin by very small
perforations, from which a discharge of viscid humour takes place. The
complaint called favus is nearly allied to it in appearance, since it
consists of larger perforations resembling the combs of bees, containing
a honey-like fluid. They are occasioned by a nitrous and saltish phlegm.
In such cases, the diet should consist of wholesome food; and everything
that is acrid and saltish should be avoided, more particularly if the
attack be inflammatory. After the proper evacuation of the prevailing
humour, having shaved the hairs, foment twice, thrice, or oftener, with
warm water, in which has been boiled myrtle, bramble, or lentil, or
bitter lupines, or the root of asparagus. When the ichorous discharge is
greater, apply a cataplasm of the leaves of willow, with water, or of
lentil. The ointments used should consist of Cimolian, Cretan, or Samian
earth, or pompholyx, or spodium, or litharge, or cadmia, or burnt paper,
or the powder from pepper. All these are to be applied with vinegar. We
may use the following smegma: Of sulphur, of the herb perdicias, and
soap, of each equal parts. The following are compound applications: Of
litharge, dr. xvj; of the leaves of rue, dr. viij; of the stavesacre,
dr. iv; of copperas, dr. ij; with vinegar and myrtle oil; make to the
consistence of bath-sordes, and anoint with it.—_Another_: Of sandyx
(_calcined ceruse?_), dr. iv; of myrrh, dr. iv; of native sulphur, dr.
ij; of manna, dr. iv; rub into the part with old oil.
_For achores._ When they discharge ichor, triturate the dross of silver,
or yellow ore of lead (_molybdœna_), and sprinkle upon them.—_Another,
for achores and humid psora_: Of the roses of the rhododaphne, oz. iv; of
native sulphur, oz. iv; of liquid pitch, oz. iij; of dry pitch, oz. iij;
of wax, oz. vj; of myrtle oil, q. s. For children, dissolve in milk, and
anoint.
_For fici._ We give the name of fici to ulcerous excrescences which are
round, somewhat hard, red, and accompanied with pain. They arise for the
most part on the head, but also sometimes on the other parts of the body.
The best application for this complaint consists of fissile alum, of the
calcined flowers of copper, of taurocolla, of each equal parts, with
double the quantity of the flakes of copper; triturate with vinegar, and
anoint. A proper application is also prepared from the burnt heads of the
cackrel fish, the bulbi boiled, and their ashes mixed with vinegar.
_A dry application for ficose eruptions of the head and chin._ Of misy,
dr. iss; of chalcitis, dr. iiss; of squama æris, dr. j; of fissile alum,
dr. j. Having washed, apply this powder in a dry state unsparingly, and
allow it to remain. Next day, having again washed, wipe the part with a
sponge, and apply it again. A thick scab will then fall from the ulcer.
Repeat the same application the following days. The cure will be effected
in a few days without leaving a cicatrix; but this medicine operates
strongly.
_For lice in the head._ Direct the head to be scrubbed with the decoction
of lupines; or pound together stavesacre and sandarach, and rub them in
along with oil or vinegar; or a small quantity of pepper may be added to
old oil, so as not to occasion ulceration; or the juice of ivy with honey
may be used; or mustard and vinegar; or the gum vernix, or liquid pitch
with alum; or the expressed juice of the bay berries; or oil of radishes.
I have always succeeded by pounding stavesacre with vinegar and oil, and
anointing with this.
* * * * *
COMMENTARY. Drs. Willan and Bateman agree with all the best medical
writers of antiquity in describing, by the name of _pityriasis_, a
disease consisting of slight, scaly, and branny exfoliations without
ulceration. See Galen (Sec. Loc. i); Alexander (i, 3); Oribasius (Synops.
vi, 25); Aëtius (vi, 66); Actuarius (de Sig. Morb. ii, 5); Nonnus (4.)
Actuarius, who gives a very distinct account of the disease, states in
strong terms the danger of repressing the cutaneous eruption. (l. c.)
It is the _porrigo sicca_ of Celsus (vi, 2), who recommends for it
shaving the head, and using slightly repressing applications, “quale est
nitrum cum aceto, vel ladanum cum myrteo et vino, vel myrobalanum cum
vino.” Marcellus distinguishes the pityriasis from porrigo. (De Med. 4.)
The Arabians, especially Serapion, direct very active general treatment,
such as venesection, masticatories, cathartics, and the like. (i, 4.)
It is described under the name of _furfures capitis_ by the translator
of Haly Abbas. (Theor. viii, 18.) Like the Greeks, he represents
it as consisting of small furfuraceous scales without ulceration.
Alsaharavius uses the same name, and recommends bleeding, cupping,
purging, and external applications of a detergent nature, such as flour
of vetches, with vinegar and the like. Avenzoar recommends pills of
drastic purgatives, and the ordinary lotions. (i, 1, 10.) See also
Avicenna (iv, 7, 1, 24); and Rhases (ad Mansor. v, 1; Contin. xxxvi.)
In the ‘Continens,’ the disease is described by the names of furfures
and impetigo, for which Rhases recommends liniments containing nitre,
sulphur, hellebore, vinegar, &c.
Willan and Bateman describe the _psydracia_ as being small pustules
irregularly circumscribed and terminating in a laminated scab. Most
of the above-mentioned writers treat of them in the same terms as our
author. They seem to be the _balchie_ of Avicenna (iv, 7, 6, 1) who calls
them a malignant species of achor. See Galen (l. c.)
Galen, Alexander, Aëtius, and our author describe the _exanthemata_ as
being small superficial ulcerations. Drs. Willan and Bateman use it as
a generic term for rashes. The exanthemata seem to be the _alraba_ or
_pustulæ dulces_ of Alsaharavius (i, 10.) See Book First, Sect. VI, and
Book Fourth, Sect. VIII, of this Work.
Willan and Bateman apply the terms _achor_ and _favus_ in the same sense
as Paulus and the other ancient authors. Octavius Horatianus uses the
terms acora and cerio. He says, “Acoræ et ceriones distant, quod ceriones
plures cavernas egestionis habent et humorem multo pinguiorem emittunt;
acora autem unam cavernam habet, et humorem egerit aquatiorem.” (i, 5.)
Galen has treated of these complaints very fully, and his applications
are similar to those of our author. See also most of the authorities
on pityriasis. The favus is the first species of _tinea_ described by
Haly Abbas. It consists, he says, of cells, and discharges a fluid-like
honey. The achor is his _amada_, or third species of _tinea_, consisting
of smaller cells than the former. Alsaharavius describes the favus by
the name of _alsahara_. It contains, he says, a viscid fluid like honey.
He recommends for it purgatives, and detergent applications containing
nitre, lees of wine, &c. (Pract. i, 9.) The achor is called _alsahafa_ by
him. The description which Actuarius gives of papulæ, favus, and ficus is
sufficiently distinct, but not different from our author’s. (De Diagnos.
ii, 5.)
The other authorities gives the same account of _ficus_ as Paulus. It
is Haly Abbas’ second species of _tinea_, and is described by him as
consisting of hard round protuberances. Haly’s fourth species of _tinea_
consists of small ulcers of a mammiform appearance. They are mentioned
by our author. Fabricius ab Aquapendente defines the ficus thus:
“Tumeur qui est rouge, ronde, quelque peu dure, et de laquelle (etant
ulcérée et pressée) sort une matière sanieuse, semblable aux grains de
figues.” (Œuv. Chir. i, 1, 13.) He says that Hippocrates and Galen give
a different account of it from our author’s; but we can see very little
difference between them. Most of the ancient authors recommend the same
remedies for ficus as Paulus. The most active of these are stavesacre,
and sandarach or red sulphuret of arsenic. They do not appear to have
apprehended danger from the free use of arsenic in this way. Galen
recommends equal parts of white hellebore, stavesacre, and nitre with
oil. (De Med. Sec. Loc. i.) Octavius Horatianus mentions equal parts of
pellitory and galls. The same medicines are recommended by Serapion, (i,
5.) See also Oribasius (de Loc. Affect. iv, 11); Celsus (xi, 3); Cælius
Aurelianus (de Morb. Tard. iv, 2.) Haly’s remedies consist of galls,
litharge, mercury _killed_ (sublimed?), sulphur, and so forth. Among
those of Rhases we remark squills, assafœtida, quicklime, mercury, &c.
However, he prefers excision. (Continens. xxxvi).
For pediculi in the head, the Arabians recommend nearly the same
compositions as our author. They contain arsenic, stavesacre, hellebore,
nitre, and the like. See Alsaharavius (Pract. i, 16), and Phases
(Cont. xxxvi, 6.) Among the ingredients mentioned by the latter, we
remark quicksilver, sulphur, red arsenic, mustard, stavesacre, the
oil of oleander, vinegar, &c. These medicines form the ingredients in
the compositions recommended by modern writers on this complaint. See
Plempius (de Morbis Pilorum), and Amatus Lusitanus (Curat. 58.)